Fish Oil for Breast Cancer Patients Undergoing Chemotherapy
Fish Oil for Breast Cancer Patients Undergoing Chemotherapy
Various studies have reported a decrease in antioxidant levels and an increase in reactive oxygen species (ROS) in patients with breast cancer post-chemotherapy. Such reduced antioxidant status and enhanced ROS often lead to various side effects such as nephrotoxicity, cardiotoxicity and peripheral neuropathy that hamper tumor treatment and may even lead to a patient's death. The antioxidant enzymes such as SOD, GPx and CAT work together in human cells to remove the toxic ROS. However, the role of omega-3 fatty acid supplementation in the modulation of antioxidant status has not been properly evaluated at the clinical level. In our study, all the patients were found to show significant improvement in their antioxidant status in RBC and plasma fractions after FO supplementation.
Recently, nutrition has become one of the most important aspects in cancer management. Reduced nutrition and subsequent poor health lowers antioxidant status, which may be associated with increased neoplastic activity in patients with cancer. An antioxidant rich diet has been shown to enhance the chemotherapy response and improve the QoL in patients by minimizing the side effects of chemotherapeutic drugs. Supplementation of vitamins C and/or E before and after breast cancer diagnosis, as well as radiation and hormone therapy, has been shown to protect against chemotherapy-related side effects through an increase in SOD, CAT, glutathione (GSH) and GRx and a decrease in the levels of malondialdehyde and DNA damage. Similarly, the Shanghai Breast Cancer Survival Study has indicated that supplementation of vitamins E, C or multivitamins within 6 months of breast cancer diagnosis correlated with a decrease in recurrence rate and mortality. Such supplementation may also alleviate dose-limiting toxicities which would help patients to complete the prescribed chemotherapy regimens resulting in better management of cancer.
The rationale behind supplementation of EPA and DHA in patients with breast cancer was laid down by various cross-sectional studies, which showed that higher intake of these fatty acids was associated with decreased risk of cancer-related mortality. Other studies have shown that omega-3 fatty acids from fish/shell fish could decrease the risk of breast cancer and adverse events related to it. FO supplementation has been shown to: reduce malignant epithelial cell proliferation (Ki67) marker in prostate cancer; reverse cachexia in advanced pancreatic cancer; maintain patient weight and muscle mass during chemotherapy in lung cancer; improve liver and pancreas function in postoperative patients with abdominal cancer; and increase chemotherapeutic efficacy (without affecting the toxicity profile) and survival in patients with lung cancer. Based on the EORTC questionnaire, after chemotherapy and FO supplementation, patients showed improved QoL scores compared to that observed before chemotherapy (Table 2). The patients showed significant improvement in global health status after supplementation of FO during chemotherapy. Global health status is an indication of a patient's own judgment of health status and QoL. The functional status scales that included physical, emotional and social functioning were found to be significantly improved after chemotherapy and FO supplementation. The patients showed significant reduction in fatigue, pain and appetite loss scale after receiving FO during chemotherapy. Other functional or symptom scales of EORTC QLQ-C30 did not differ significantly before chemotherapy and after chemotherapy and FO supplementation.
Discussion
Various studies have reported a decrease in antioxidant levels and an increase in reactive oxygen species (ROS) in patients with breast cancer post-chemotherapy. Such reduced antioxidant status and enhanced ROS often lead to various side effects such as nephrotoxicity, cardiotoxicity and peripheral neuropathy that hamper tumor treatment and may even lead to a patient's death. The antioxidant enzymes such as SOD, GPx and CAT work together in human cells to remove the toxic ROS. However, the role of omega-3 fatty acid supplementation in the modulation of antioxidant status has not been properly evaluated at the clinical level. In our study, all the patients were found to show significant improvement in their antioxidant status in RBC and plasma fractions after FO supplementation.
Recently, nutrition has become one of the most important aspects in cancer management. Reduced nutrition and subsequent poor health lowers antioxidant status, which may be associated with increased neoplastic activity in patients with cancer. An antioxidant rich diet has been shown to enhance the chemotherapy response and improve the QoL in patients by minimizing the side effects of chemotherapeutic drugs. Supplementation of vitamins C and/or E before and after breast cancer diagnosis, as well as radiation and hormone therapy, has been shown to protect against chemotherapy-related side effects through an increase in SOD, CAT, glutathione (GSH) and GRx and a decrease in the levels of malondialdehyde and DNA damage. Similarly, the Shanghai Breast Cancer Survival Study has indicated that supplementation of vitamins E, C or multivitamins within 6 months of breast cancer diagnosis correlated with a decrease in recurrence rate and mortality. Such supplementation may also alleviate dose-limiting toxicities which would help patients to complete the prescribed chemotherapy regimens resulting in better management of cancer.
The rationale behind supplementation of EPA and DHA in patients with breast cancer was laid down by various cross-sectional studies, which showed that higher intake of these fatty acids was associated with decreased risk of cancer-related mortality. Other studies have shown that omega-3 fatty acids from fish/shell fish could decrease the risk of breast cancer and adverse events related to it. FO supplementation has been shown to: reduce malignant epithelial cell proliferation (Ki67) marker in prostate cancer; reverse cachexia in advanced pancreatic cancer; maintain patient weight and muscle mass during chemotherapy in lung cancer; improve liver and pancreas function in postoperative patients with abdominal cancer; and increase chemotherapeutic efficacy (without affecting the toxicity profile) and survival in patients with lung cancer. Based on the EORTC questionnaire, after chemotherapy and FO supplementation, patients showed improved QoL scores compared to that observed before chemotherapy (Table 2). The patients showed significant improvement in global health status after supplementation of FO during chemotherapy. Global health status is an indication of a patient's own judgment of health status and QoL. The functional status scales that included physical, emotional and social functioning were found to be significantly improved after chemotherapy and FO supplementation. The patients showed significant reduction in fatigue, pain and appetite loss scale after receiving FO during chemotherapy. Other functional or symptom scales of EORTC QLQ-C30 did not differ significantly before chemotherapy and after chemotherapy and FO supplementation.
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